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Blog Posts in September 2017

Just returned from the Sunshine State where I enjoyed a weekend with a warm group of mostly Floridian movement scientists discussing acetabular-femoral position's effect on laterality and the ability to enjoy balance in gait for the full gamut of athletes--seated to high flying. Thoroughly enjoyed the discussions about integrating PRI primary course principles into all populations, treating forwardly rotated coxal bones with triplanar effectiveness, and application of specific, appropriate techniques.

On a weekend where most participants had been through a couple weeks of significant change prior to and following Hurricane Irma, I felt nothing but welcomed by all course participants during a weekend that passed like a blink! Thanks Orlando, looking forward to PRI nation flourishing in your region!

Impingement and Instability - (Indianapolis IN). Enjoyed a great weekend in Indianapolis with Bill Hartman and the IFAST crew exploring the secondary level PRI course Impingement and Instability. A big thank you to Bill and his entire staff for making me feel so welcome and for taking such good care of me throughout the weekend.

We started the course with an explanation of lateralization and the physiological and neurological reasons behind the lateralized tendencies seen with the Left AIC/Right BC pattern. We introduced a strong frontal plane approach to calcaneal performance and also to the gait cycle, emphasizing frontal plane ankle and hip strategies to help manage human lateralization.

We moved into a discussion of femoral orientation and compensation patterns that can destabilize the lower kinematic chain and cause problems with the tibial - femoral relationship. We talked about how these patterns can directly cause knee pain and knee dysfunction, and also talked about patterns that don't necessarily cause knee pain, but still need to be properly managed because they often contribute to problems in other areas. Thank you Bill for both your questions and your comments in this regard.

The second day included discussions about ilial instability and scapular instability. The relationship between the iliacus and the glute medius as functional performers for the pelvic inlet to stabilize the ilium in the frontal plane was discussed. As it relates to scapular instabilities, we looked at the frontal plane function of the low trap and compared it to sagittal plane function on both sides. We also evaluated the frontal plane function of the serratus anterior and compared it to the sagittal plane function on both sides. We finished our scapular Instability discussion with demos and overview of subscapularis as a true internal rotator of the shoulder joint once position and proper lateralization was established.

Deep in the heart of Texas! Cervical Revolution at Goddard Orthopedic and Sports Therapy. GO Sports Therapy is a beautiful facility owned by Amy Goddard, a fantastic PRC who has taken PRI concepts to a high level in The Dallas area. She, along with my good friend Stephanie Irizarry, who is also a PRC and Gail Kaiser who is Orthopedic Certified (and a marathon running beast!) took the job of hosting and made me and the entire class feel very welcome. I am so very grateful for their wonderful hospitality. The class of 30 participants included multiple PRC's and two PRT's in attendance as well: Tara Osborne PRC, Anita Panagiotis PRC, Kasey Aikin PRC, Jennifer Bullock PRC, Amy Goddard PRC, Stephanie Irizarry PRC, James Guzman PRC, Taylor Lewis PRT and Sayuri Abe-Hiraishi PRT...wow!! We covered the causes of two main osteopathic cranial strains known as the Left Cranial Side Bend and Right Torsion Lesions. We also discussed malocclusions and the interrelationships of both. This led us into a journey through the asymmetric human form that was so very enlightening and helped the course attendees develop a mechanism for not only management of the cervical system but also a mechanism for interdisciplinary work with their local dentists. We had three dentists in attendance with us: Peter Lecca DDS, Anh Khieu DMD and Orthodontist Yoon Chang DDS, MS. I had Dr. Chang take the podium at the end of the course and deliver a bonus lecture on orthodontics from a cranial strain restoration point of view and it was excellent. Thank you Dr. Chang and thanks to all in attendance. It was a blast!

I had a great weekend at Ethos Colorado in Denver presenting the PRI Integration for Fitness and Movement Course. Ethos had a great facility and thank you to Jonathan Pope and his team for hosting! We had a jammed pack Saturday discussing important concepts to enhance athletic durability and how to empower the breathing system. Diaphragm and ribcage mechanics were broken down to help professionals assess proximal core stability and postural health. Sunday was even more jammed back with discussion around our asymmetrical design and the common patterned imbalances we see in our clients. Components of gait were correlated with various fitness movement patterns and exercises were broken down into planes of motion to empower better programming and triplanar sequencing. I am thankful for the great feedback received from all attendees. This course continues to improve and offers the experienced PRI clinician with gems of applicable knowledge as well as offers invaluable neurorespiratory insight to a new attendee to enhance their understanding and assessment for mobility, stabilization and strength. Two more courses left for 2017! James and I will be in Minneapolis teaching next month and in the DC area teaching in November. There is still room to sign up! Check out the Affiliate Course link under Programs and Courses on the PRI website.

PRI Integration for Geriatrics - (Chapel Hill, NC) It was an awesome weekend presenting "PRI Integration for Geriatrics" to an awesome group in beautiful North Carolina. As a group, we explored the possibilities of the course's new title and the new subtitle, "Restoring Alternating Function in the Immobile, Frail and Chronic". By the end of the weekend, we had identified a lot of great applications for immobile populations, frail populations and chronic populations across a large spectrum of conditions and age groups. It was eye opening for all of us and a great validation that the course's new name really does reflect who this material is for.

A big thank you to Susan Henning, PT, PRC and her wonderful team at the host site Advance Physical Therapy. She was a great lab assistant and a kind, generous host throughout the weekend. She has assembled a fantastic team of professionals in their dynamic integrated clinic. Thank you Joe Belding, Jean Massé, Lisa Mangino, Shella LoBianco and Beth Elder for being an important part of a great learning weekend. Honestly, to have 4 out of 6 staff members at the host site currently certified in PRI and the other 2 interested in the process of getting certified is very uncommon and even a little intimidating for a presenter with an introductory affiliate course like this. But your feedback confirms that this material was a nice combination of introductory and advanced concepts that challenged you and also rewarded you for being there. I love to be able to connect with and challenge both first time attendees and also experienced PRI clinicians with affiliate course content and all the new assessment and treatment ideas.

This weekend also provided me an opportunity to meet some people from my early PRI faculty days and associate with some of the people they are now able to mentor and influence. Rebecca Williams, PT from Pinehurst, NC, who has incidentally become a good friend of our very own Jen Poulin, reminded me that she attended one of my first ever courses as a PRI faculty back in 2001, a Protonics course in Columbia, SC. That course was also my first opportunity to meet and teach another longstanding PRI contributor and good friend, Kyndy Boyle. Wow, a lot of positive things have happened with this institute since those early days, and mostly because of the people we were fortunate enough to meet along the way. I also met 2 PTAs this weekend who are currently employed by a therapist I first met and taught when she was a student in PT school, Tracy Lyn Schuster, DPT. Madison Blythe and Hailey Parsons, you two did a great job with the material and Tracy Lyn would have been very proud of you. And thank you Madison for suggesting Merritt's Grill for lunch on Saturday. That place could be one of my all time favorite places to eat lunch anywhere in the country.

Lastly, I want to thank my friend JR Glenn for coming over from Columbus Ohio to attend the course and also to help me work through one of the long-standing emotional issues in my life - an inability to get over the hard feelings I have for the 1991 Duke University Men's Basketball Team. I attended UNLV in the early 90s and the 1991 Blue Devils prevented my Running Rebels from being back to back National Champions and I haven't forgiven them for breaking my heart. JR was kind enough to drive me from Chapel Hill across town to Durham to face my unhealed wounds at Duke University. We visited Krzyzewskiville, Cameron Indoor Stadium and then I got to see the 1991 National Championship trophy with my own eyes. After working through the pain of it all and reminding JR that the trophy should not be in a glass case in Durham, but instead in a glass case in Las Vegas, I let go and began the healing process. I'm optimistic about my ability to get over this barrier in my life. I'll definitely keep you posted. Go Rebels!

I thoroughly enjoyed my weekend with an integrated group of clinicians at One on One Physical Therapy in Atlanta Georgia. I taught Pelvis Restoration for the first time since we updated the material to use the HABLT vs. the HADLT for progression of treatment. The test surely is a better assessment tool for the frontal plane of proximal pelvic control. My course attendees were almost an even split of those that were sitting in their first PRI course and those that were very experienced with the science. There were many questions and scenarios discussed and I of course love sharing my clinical pearls to help course attendees understand how to integrated PRI into their treatment plans.

My hostess was fantastic! Karen Warren and her colleagues were gracious and she is excited about hosting future PRI classes! I was joined by Kristen Spencer and Adrian Baker as my lab assistants. These ladies did a great job helping the class during lab and supporting me this weekend. It is always fun to have my friend Liz Caughey, DDS in a PRI class. So cool that she as a dentist wants to understand PRI science as it relates to everything other than just teeth. This lady is so cool. A special shout out to Henry Pursner for making sure my technology was working and my coffee cup was always full. I was well taken care of this weekend.

On a personal note, my heart goes out to all of those recently affected by Hurricane Harvey and Hurricane Irma. I was fortunate to be able to stay with my sister Jacki and her family this weekend as they reside just north of the perimeter in Alpharetta! I was able to fly out of Atlanta on Monday am just before Irma unleashed on Atlanta! I did get home in time to watch my daughter play her cross county rivalry Volleyball game. They came back after being down 0-2 and in the third set 19-24 to win in 5 sets of Volleyball!!

As a PRI Instructor, it's not often we have the opportunity to have a true "home game," but that's what we had this weekend with Myokinemtic Restoration. I had the opportunity to teach and collaborate with a great group of individuals with diverse backgrounds in my home clinic. And, since it was a home game, it was great to collaborate with my co-worker, Donna Parise Byrne, PT, PRC. We had a fantastic discussion about the positional tests in PRI, and how to look at them differently now that we can find and appreciate the human asymmetry inherent in the L AIC pattern. We had the opportunity to find and feel muscles during the lab section, and we had a great demo regarding how to approach an individual who has a more of a PEC presentation than a L AIC presentation. We talked about there are times to be "Batman," and times to be "Bruce Wayne." We talked about our Internal Rotation Boy Band and why we need to keep the band together. And we talked about how the hamstring is the Gate Keeper of the Gait Cycle. My thanks to Zach Lloyd, Jayson Leisenring, and Elizabeth Manning for being our models for the course, and allowing us to learn from them. It was great to have my friend of 15 years, Rick Noelte, in attendance as well. And great questions and dialogue with Susan Rocchini, Erik Smith, Aaron Doering, Julia Glick, Hetal Patel, and Kim Greenstein. Everyone in the entire group had great questions, and it was a pleasure to have everyone at our "home game!"

The Institute of Community Wellness and Athletics (ICWA) hosted Postural Respiration in Albuquerque, NM Sept. 9-10. This course was a faculty member's dream! Most of the class attendees were brand new to PRI or had only taken Myokin or a home study course previously. From the very start, the curiosity and attention was palpable and students followed closely every step of the way into a PRI weekend journey of challenge and discovery. Questions were plentiful with great re-states of concepts and honest feedback that, yes, the amount of information in this course can feel daunting for first time attendees but they wanted to hang in and work hard to really get it! The questions directed repetition from many angles that led to understanding of the basic principles of PRI. One of the many topics that vexes new attendees ( It certainly vexed me at first!) is Superior T-4 Syndrome. What helped was a strong foundation that everyone absorbed on rib kinematics driving a spinal column and that ribs are driven by respiration and respiration is driven by neurological patterns. These guys got it. What helped for the strength and conditioning group was that scalenes are like "Romanian Dead Lifters" lifting upper ribs creating a patho-mechanical pattern of respiration. Before lecture on James Anderson's page 50 in the Appendix on Thoracic Airflow, Typical BC and Superior T-4 Syndrome, the class had had a demonstration on a "long tall Sally/Sam" that demonstrated BC testing, then manual restoration techniques including Superior T-4 technique to assess for Superior T-4 Syndrome and then identifying when and why a manual Subclavius Release is needed. Then they assessed and practiced the two manual techniques after being shown what the reasoning behind the assessment and manual approach. The lecture into Page 50 just made sense to these new students since they could apply a concept to actual experience that they just practiced in lab and could now apply since they had a better picture in their minds as to what patho-mechanical respiration is and how to identify and treat with manual and non-manual techniques. The enthusiasm, especially on Sunday afternoon after an information/paradigm changing weekend can feel over-whelming, was just great. Thank you Nathanael Smith and Jonathan Esquibel for being great site hosts and especially Jessica Kisiel, PRT for assisting! In this faculty member's opinion, New Mexico will be a great new state for PRI and I hope to be invited back! Myokin will be there February 2018!